Paul Farmer

So, I just found and read through some notes I took from waaaaay back in 2008 when I went to see Paul Farmer give a lecture here in Columbus. I've read nearly every single book this guy has written, and his ideas are what inspired me to want to study public health, and have really shaped the way I see health care and health systems.

So, this post is basically just going to be my notes from that lecture, so I have them in a place where they won't get lost or accidentally thrown away.

• Used worldmapper.org to compare areas of HIV prevalence to areas where physicians are working. Used it to illustrate the vast disparity in where disease lies as opposed to where doctors practice.
• Needs Assessments: Ask people what they need and then do what they say, not just follow convention (ex. G.O.B.I.=growth, oral re-hydration, breast feeding, immunization)
• Cost should be at the beginning of a conversation about treatment, not the end.
• IDA=international dispensary association
• Doctors have 2 choices: You can complain about people telling you their social problems OR you can see it as a privelage that they tell you their problems. When their physical symptoms go away, they'll start telling you about the social causes of those problems.
• Rwanda project is funded by the Clinton Foundation
• When speaking about structure and how it causes disparities: "It's easier to get from Newark to Paris than it is to get across Newark."
• Progressive vs. Regressive Health Care/Insurance Schemes: Progressive= spreads risk, Regressive=penalizes sick
• Use anthropology as a way of re-socializing problems, ex: obesity epidemic in one part of the world while we have a famine in another part
• You don't have to use physicians to do work for chronic illness. Physicians are a limited resource, you don't need physicians to treat illness, you need to get another resource. Must create new modes/modules or care, must get people to fund different care models.
• Our resources are mal-distributed, not limited
• A medical school faculty member asked in the Q&A session about what they should do for all their students who want to go do residencies/internships in underserved places (Africa, Haiti, etc.) Farmer's Reply: Students are driving the agenda and you faculty need to catch up! Discussed how medical schools are illequipped to train students in this type of medicine/social justice work even though students are dying to do it. He told that professor" I know your kids all want to do this, because they all call me and ask to help!" Asked if students need to be spectators of poverty or instruments of change. Talked about finding the right settings for students to work in, and that right now Universities are failing to support the public sector. Universities need to begin finding partners in underserved areas that are doing service work, not just research.
• Discussed gender disparities as a result of unequal access between women and men.
• Referred to the book "Women, Poverty & Aids"
• In Haiti, creating jobs was paramount in reducing health disparities, they created 2500 jobs in Haiti & half were to women.
• Talked about Rwanda's new mandate that half of their Parliament must be women "They are trapping themselves into decency through legislation."

Sigh! So inspired!